Joel M. Topf, MD FACP Profile picture
Nov 7, 2021 15 tweets 8 min read Read on X
Polarization in #KidneyWk Educational Community by Avrum Gillespie @AvrumGillespie
The agenda #KidneyWk
Why we tweet. #KidneyWk
Going deep into the "Social" of social media. The Left and Middle box. #KidneyWk
What is a social network. Nice demonstration of an online and offline (dialysis unit, see the pinned tweet on @AvrumGillespie twitter feed for more on that) social network. #KidneyWk
Popular people get more popular. This is called preferential attachment. His example is some clown named @Kidney_Boy #KidneyWk
Homophily, people seek attachments with people of similar beliefs and interests. #KidneyWk

Transitivity (clustering) a friend of my friend is my friend, Constraint are people that are not joint friends (I think, it was a little unclear)
Influence is more powerful than credibility. #KidneyWk
Clustering coefficients measures polarization
Eigenvector how well connected are you to someone who is well-connected
Average path length who many people does it take a message to go. (this was unclear)

#KidneyWk
Using those definitions and looking at #KidneyWk 2019 and 2020, I wonder what was different between those two conferences?
No mention on how they defined tweets on diabetic kidney disease. #KidneyWk
Seahorse vs Hagfish. Not clear if he is joking. #KidneyWk
How reduce polarization. #KidneyWk
Social Media team to defend the network. He never defines attack or defense. I have no idea what this slide means. #KidneyWk
His key data is 2019 vs 2020 #KidneyWk and he never mentioned the pandemic. Wild.

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More from @kidney_boy

Apr 13
When we published our study <> of ODS and hyponatremia we were pummeled for including people at low risk of ODS because we included Na levels between 120 and 130. They said it is well known "that ODS is incredibly rare/non-existent at those levels." 1/4evidence.nejm.org/doi/10.1056/EV…
Of course one of the reasons it was thought to be incredibly rare was that no one looked for CPM in patients with Na from 120-130. We found a fair number (≤5 of 12). 2/4 Image
Our findings are replicated in a study from Australia. The authors took a different approach to investigating ODS. Instead of starting w/ hyponatremia and working forward to ODS, they started with a dx of ODS and worked backwards
3/4ncbi.nlm.nih.gov/pubmed/35717664
Read 4 tweets
Sep 17, 2023
Gadolinium in dialysis patients.
What's up with that?
#Tweetorial
1/11
Nephrogenic systemic fibrosis (NSF) is an iatrogenic disease that presents with hardening of the skin and other organs. It is often lethal. I treated 5 people with this condition (including one with AKI). Terrible.
2/11 Image
The etiology of NSF was unknown and there were many theories. In 2006, Thomas Grobner published a small case series showing 5 patients developing NSF within weeks of receiving gadolinium contrast for MRI.
3/11pubmed.ncbi.nlm.nih.gov/16431890/
Read 12 tweets
Aug 12, 2023
I just recently recommended the Renal Physiology book by Bruce Koeppen and Bruce Stanton. I thought it was a good medical student level text book: pbfluids.com/2023/08/ouwb-s…
But I came across this question in Chapter 8 Regulation of Acid Base. It is a straight forward question asking the learner to interpret simple acid-base cases. Image
But the question falls apart when you look at the answer... Image
Read 7 tweets
Apr 14, 2023
Lab guy from Yale up next Joe El Khoury He is on YouTube. Episode 1 was on pseudohyponatemia
209 subscribers. Clinical Chemistry with Joe El-Khoury Image
Here is the YouTube channel: youtube.com/@ClinChemJoe

https://t.co/LWupt0HWN1 #NKFClinicals
Despite calling it “laboratory error”, a lot of the problem happens long before the sample gets to the lab. #NKFClinicals Image
Read 9 tweets
Apr 14, 2023
Pseudohyperkalemia
Serum potassium is higher than plasma potassium. #NKFClinicals ImageImage
Sometimes Fist clenching
Sometimes Tourniquet
in the NEJM 1990 Image
Seasonal temp effects on potassium #NKFClinicals Image
Read 8 tweets
Apr 14, 2023
Michael Emmett on electrolyte artifacts
Pre-analytical and analytical #NKFClinicals Image
Starting with pseudohyponatremia
These are real cases
The osmolality was 294, so there is a huge gap. 44ish
Implies Artifactual decrease in sodium
Her triglycerides were >6000 #NKFClinicals Image
Note the different between HCO3 and tCO2 should be closer than 19 and 9. #NKFClinicals Image
Read 12 tweets

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